Objectives: This study aimed to estimate the proportion of tuberculosis patients among children and adolescents, to describe the socio-demography and clinical factors for tuberculosis infection among children and adolescents in Kelantan from 2012 until 2015. Methods: This study was a retrospective cross-sectional study between tuberculosis and non-tuberculosis cases among children and adolescents using Tuberculosis Information System as a source population. All notified cases that fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics, simple and multiple logistic regressions were used for data analysis. Results: Out of 5412 tuberculosis cases, 8.4% were children and adolescents group with mean age of 15. Among 322 children and adolescents with tuberculosis, majority of them were Malay (91.2%), 7.5% illiterate and 79.6% resided in non-urban area. By clinical factors, 2.8% were Human Immunodeficiency Virus (HIV) positive and 14.6% were cigarettes smokers. Older age, cigarettes smoking, female gender, Malay ethnicity, good education level and non-urban residence were the significant associated factors for tuberculosis infection among children and adolescents with AOR 1.41 (95%CI: 1.29,1.54; p
Scrub typhus is an acute febrile illness caused by the bacteria Orientia tsutsugamushi, which can be transmitted to humans through the bite of infected trombiculid chigger mites. Besides the typical clinical features of fever and eschar formation, the central nervous system has been reported to be involved as evidenced of reported cases ranging from meningitis to meningoencephalitis. Here, we describe an atypical presentation of scrub typhus case that occurred in a 34-year-old Malay male who presented with quadriplegia following an insect bite at the back of his neck. Our case displayed unusual findings of this rare condition in a non-aboriginal Malaysian population. Based on previous literature, we emphasized the importance of prompt diagnosis of scrub typhus in order to reduce the mortality and morbidity and to improve the quality of life for patients with complications of this disease.
Evidence-based recommendations on intrapartum care are important to ensure the safety of mothers and neonates. The objective of this study was to compare two established guidelines for intrapartum care to provide clinicians with more comprehensive recommendations on intrapartum management. We carried out a descriptive analysis of guidelines from the Integrated Management of Pregnancy and Childbirth (IMPAC) guidelines published by the World Health Organization, and the Perinatal Care Manual published by the Ministry of Health Malaysia, on intrapartum care to determine differences, if any, with regards to management. Latent, active and the second phase of labour are defined differently in both guidelines. Both guidelines showed high similarity in the steps of clinical management for all phases of labour but differed in foetal monitoring methods, indications for episiotomy, mood and behavior assessment, universal precautions, pain management, and placental disposal. Both guidelines had similar managements for most of the problems encountered during the intrapartum period except for preterm labour and multiple births which have substantial differences. Malaysian guidelines highlight additional systems such as the red alert system, and referral and retrieval system, which would enhance the quality of intrapartum management. The IMPAC guidelines emphasize supportive care, birth companionship, maternal care and monitoring up to one hour after placental delivery; and home birth management; these are inadequately explained or lacking in Malaysian guidelines. From the comparison, it was seen that substantial variation exists in intrapartum management between both guidelines that indicates the need for better evidences to synthesize a more comprehensive set of guidelines for the improvement in intrapartum care.
Introduction: The need for client feedback in assessing healthcare services is widely recognized. However, little is known about the satisfaction of adolescent clients utilising healthcare services in Malaysia. To the best of our knowl-edge, there is no validated instrument to measure the satisfaction of adolescent clients attending health clinics in Malaysia. The objective of this study was to determine the reliability of the Malay Version of the Ministry of Health’s Adolescent Client Satisfaction Questionnaire among adolescents attending health clinics in North-eastern Malaysia. Methods: A cross-sectional study was conducted in January 2019 among adolescents aged ten to nineteen years old that attended four designated health clinics in the Kelantan state of Malaysia. The test for Cronbach’s alpha was per-formed to determine the internal consistency reliability. Results: There were a total of 85 adolescent clients involved in this study. The mean age of the respondents was 15.6 years old. Majority of respondents were female, Malay, students and attained secondary level of education. The internal consistency reliability was good as the Cronbach’s alpha of the domain was 0.854. The corrected item-total correlation for the domain was acceptable as it was 0.4 and above. Conclusion: The Malay Version of the Ministry of Health’s Adolescent Client Satisfaction Questionnaire showed excellent internal consistency reliability. Therefore, it may be recommended to be used as a tool to measure the satisfaction level among adolescents attending health clinics in Malaysia.
Introduction: The Ministry of Health Malaysia introduced the national best practices for adolescent-friendly health services in 2018 and it served as an assessment tool in the accreditation of adolescent-friendly clinic status. This study was conducted in Kelantan with the objective to determine the proportion of adolescent-friendly clinics and its determinants and perceptions of healthcare providers regarding the facilitating factors in providing adoles-cent-friendly health services. Methods: The research design was sequential explanatory mixed method. State wide clinics assessment was done to estimate the proportion of adolescent-friendly clinics and to determine the factors associated with adolescent-friendly health services provision. Perceptions of healthcare providers on the facilitating factors for adolescent-friendly health services were explored through in-depth interviews. Descriptive statistics and linear regression analysis were performed for quantitative data, and thematic analysis for qualitative data. Results: Out of 85 health clinics, 30 (35.3%) clinics were accredited as adolescent-friendly. Availability of trained health-care providers in adolescent health modules, private room for adolescent counselling, dedicated team in charge of adolescent programme and adolescent health promotional activities were the statistically significant determinants for adolescent-friendly health services (p